مجله دانشکده پزشکی اصفهان (Aug 2011)
Effect of Additioning of Triamcinolon to Cocktail of Fentanil Epinephrinated Bupivacaine in Periarticular Injection for Post Operative Pain and Quality Improvement after Total Knee Arthroplasty
Abstract
Background: Today, total knee arthroplasty surgery is on the rise in the world. One of the characteristics of this surgery is severe post operative pain. The aim of this study was to evaluate the effect of priarticular injection of Triamcinolon on post operative pain and the function of replaced knee after total knee arthroplasty. Methods: This clinical trial was performed on 64 patients 20 to 80 years undergoing to elective knee arthroplasty surgery. Patients were randomized into two groups (32 patients in each groups). The study group received periarticular injection of triamcinolone acetonide, fentanil, bupivacaine and epinephrine. The control group received only fentanil, bupivacaine, epinephrine and normal saline. Periarticular injection was done by surgeon. The amount of pain, using verbal rating scale (VRS) during recovery, 6, 12, 24 and 48 hours after surgery and articular function (by knee society knee score) were assessed as initial outcomes. The collected data was analyzed by SPSS version 18 by using student t-test and Man-Whitney test. Findings: This clinical trial was performed on 64 patients 20 to 80 years undergoing to elective knee arthroplasty Findings: There were not any significant difference in mean of pain score between two groups in recovery, 6, 12 and 24 hours after surgery (P > 0.05). The mean of pain score in 48 hours after surgery was significantly less in study group (P < 0.05). Morphine consumption after 48 hours was significantly less in study group (P = 0.0001). There is a significant different in articular function (range of motion and walking) between two group base on knee society knee score. There was a greater satisfaction in the study group than control group (P = 0.04). Conclusion: These results shown that the use of periarticular triamcinolon can reduced acute and long term post operative pain and improved articular function and long term good sense in patients.
